Caring For Your Little One

How do I soothe my crying baby? I get so distressed when she is fussy.
Your baby’s cry can be the most frustrating sound you ever hear and, as a parent, you are hardwired to try to relieve her distress. Follow these steps to soothe your baby — and yourself.

First, remain calm. Your baby will pick up on any stress you exhibit, which might lead to more crying. Young babies typically cry up to three hours per day, so expect some crying and roll with it. Remember that babies cannot yet speak, so crying is one of their principal forms of communication.

Second, try to identify what’s making your baby upset and try to fix it. Common causes of crying are hunger, needing to burp, a dirty diaper, feeling too hot or cold, sleepiness, being overstimulated or simply wanting a little extra attention. If you don’t know what’s causing your baby to cry, try one (or more) of the suggestions that follow.
• Feed her.
• Burp her.
• Change her diaper.
• Remove or add layers of clothing.
• Swaddle her.
• Dim the lights and put on calming music or white noise.
• Carry her.
• Rock her back and forth.
• Play with her.
• Nurse her or offer a pacifier or your clean pinky finger.

It might take a few tries before you know what your baby needs, and sometimes a combination of these techniques does the trick. Rarely, a baby’s cry signifies something more serious, such as an illness or inquiry. You should seek medical attention if your baby cannot be soothed after hours of trying, or if you think something is not quite right.

Lastly, if your baby’s crying is threatening to push you to the breaking point, go back to step 1 and remain calm. For your own sanity and your baby’s safety, it’s fine to put her down in a safe place and walk away for a short time to collect yourself. Breathe deeply, phone a friend for support or eat a healthy snack. Make sure to take care of yourself, because as soon as the crying episode is over, the countdown starts for the next one!

My five-month-old seems to be behind other babies his age. What should he be doing at this point, and will he catch up?
It’s natural to compare your baby to others, and to worry if he doesn’t seem to be doing some of the things you notice other babies doing. Although you are likely to be observing normal variation, it can be helpful to examine the situation more closely.

Developmental milestones are skills that most babies have accomplished by a certain age. When these milestones aren’t reached “on time,” there may be cause for concern. Skills that most five-month-olds have mastered follow.

• Motor: Babies reach for toys with an open hand, hold a toy and shake it, bring objects to their mouths, bear weight on their legs while held upright, push up on their forearms when placed belly-down and roll over from back to front.

• Language/communication: Babies coo, babble, try to imitate the tone and rhythm of your speech and have different cries for different needs.

• Social/emotional: Babies smile spontaneously (especially at people or when looking in a mirror — this is called the social smile), like to play with people and might cry when the playing stops, copy facial expressions and express happiness or sadness.

If your baby hasn’t reached these milestones, or if you just have a feeling that something isn’t quite right with his development, bring it up to his pediatrician at the next appointment. Sometimes the right course of action is to continue monitoring development closely and, occasionally, a more thorough examination must be done. It’s reassuring to know that most babies with a developmental delay will catch up to their peers with a little help.

How will I know if my baby is gaining the right amount of weight? Is there a difference in weight gain with breastfeeding vs. formula?
Newborns typically range from about five-and-a-half to eight-and-a-half pounds at birth, and lose about seven to ten percent of their weight in the first few days, after which they rapidly gain it back — and then some! Weight gain in the first month is about an ounce per day. It slows down after that, but not by much — at four or five months most babies will weigh twice what they did at birth, and by a year they generally weigh about three times their birth weight.

Your pediatrician will monitor your baby’s weight at every visit by using a growth chart, which assigns a percentile to measurements of weight, length and head circumference. Your baby’s percentile represents where he stands with respect to other babies of the same age. For example, if your baby is at the 40th percentile for weight, it means that about 40 percent of same-age babies weigh less and about 60 percent of babies weigh more than he does. Many babies start life at one percentile and eventually settle at a different one.

Breastfed babies often gain weight faster than formula-fed babies in the first few months, after which the two groups tend to even out. Because milk can come out of a bottle very rapidly, an infant who feeds from a bottle, whether it contains formula or breast milk, is at risk for overfeeding and associated unhealthy weight gain. On the flip side, some babies do not get enough milk through breastfeeding, and may need some supplemental bottle-feeding to keep their weight gain on track.

It’s important to avoid concentrating on a single feeding session or weight measurement when making the determination that a baby is eating and growing well. Your pediatrician is trained to notice concerning growth patterns, so make sure to go to all of the recommended well-baby visits.

Pediatrician Elizabeth Shashaty, MD, is on staff at Children’s National Medical Center and Medstar Georgetown University Hospital, both in Washington, DC. She is also the mother of three young children.

Have a question about your newborn or about being a new parent? Email em@cwpg.com.